Treatment preference for once-weekly versus once-daily DPP-4 inhibitors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Although once-weekly and once-daily DPP-4 inhibitors have gained widespread market recognition, patient preference differences remain a key focus. This meta-analysis compares treatment preferences for once-weekly versus once-daily DPP-4 inhibitors in T2DM, offering evidence to guide clinical decisions and healthcare policies. PubMed, OVID, EBSCO, Web of Science, CNKI, Wanfang, and clinical trial registries were searched up to June 30, 2025. After screening literature against predefined criteria, a systematic review was conducted to compare the effects of once-weekly and once-daily DPP-4 inhibitors on the treatment preferences of patients with T2DM. 8 RCTs with 1,575 participants were analyzed. No significant difference in medication adherence and DTSQ total score between the once-weekly and once-daily groups (<i>p</i> &gt; 0.05). HbA1c percentage (MD = -0.21, 95% CI [-0.42, -0.01], <i>p</i> &lt; 0.05) decreased significantly with once-weekly dosing, while GA and FPG showed no change (<i>p</i> &gt; 0.05), this suggests greater improvement in HbA1c percentage levels following a switch to once-weekly DPP-4 inhibitors. Once-weekly DPP-4 inhibitors showed higher musculoskeletal/connective tissue disorder risk (RR = 2.63; 95% CI [1.18, 5.83]), but no significant differences in other adverse events (<i>p</i> &gt; 0.05). No significant differences in treatment burden between both groups (<i>p</i> &gt; 0.05). No statistically significant association between treatment preferences for once-weekly versus once-daily DPP-4 inhibitors among T2DM patients and medication adherence, treatment satisfaction, glycemic level changes, safety, or treatment burden for these two dosing regimens. Further research is needed to elucidate the influence of physician prescribing behavior on these preferences.

尽管每周一次与每日一次的二肽基肽酶-4（DPP-4）抑制剂已获得广泛的市场认可度，但患者用药偏好差异仍是当前的核心研究焦点。本荟萃分析（meta-analysis）针对2型糖尿病（T2DM）患者对每周一次与每日一次DPP-4抑制剂的治疗偏好展开对比研究，旨在为临床决策与医疗政策制定提供循证依据。
研究检索了截至2025年6月30日的PubMed、OVID、EBSCO、Web of Science、中国知网（CNKI）、万方数据（Wanfang）及临床试验注册库。
按照预设纳入排除标准对文献进行筛查后，本研究开展系统综述，对比每周一次与每日一次DPP-4抑制剂对2型糖尿病患者治疗偏好的影响。
最终纳入8项随机对照试验（RCT），共包含1575名受试者进行数据分析。
每周一次组与每日一次组在用药依从性及糖尿病治疗满意度问卷（DTSQ）总分上均无显著统计学差异（p>0.05）。
每周一次给药方案下的糖化血红蛋白（HbA1c）百分比显著降低（均数差MD=-0.21，95%置信区间CI[-0.42, -0.01]，p<0.05），而糖化白蛋白（GA）与空腹血糖（FPG）水平未出现明显变化（p>0.05），提示换用每周一次DPP-4抑制剂可更有效地改善糖化血红蛋白水平。
每周一次DPP-4抑制剂的肌肉骨骼/结缔组织紊乱不良事件风险更高（相对风险RR=2.63；95%CI[1.18, 5.83]），其余各类不良事件则无显著差异（p>0.05）。
两组患者的治疗负担无显著统计学差异（p>0.05）。
整体而言，2型糖尿病患者对每周一次与每日一次DPP-4抑制剂的治疗偏好，与用药依从性、治疗满意度、血糖水平变化、安全性或两种给药方案的治疗负担均无统计学意义上的显著关联。
未来仍需开展进一步研究，以阐明医师处方行为对这类治疗偏好的潜在影响。